Project Peds: Sri Lanka Tsunami Relief

MGH is located in the city of Matara in the Southern District of Sri Lanka. Matara is a coastal town accessible by all major highways and rural roads in the area. Major public bus lines and trains make scheduled stops in Matara. MGH, specifically, is located several miles inland from the coast.

Matara General Hospital Facts

Patient Population & Volume

• MGH services a child-patient population of 1 million children in Matara and the three adjacent towns and rural areas.
• MGH receives patient referrals from three other area hospitals that do not have the ability to conduct investigational studies:
• Hanbanthota – 80 km away
• Tangalla – 40 km away
• Kamburabita – 40 km away

• Approximately 1000 deliveries/month
• Approximately 400 inpatients/month
• Approximately 150 neonatal admission/month
• MGH currently operates at or over capacity with a daily census of 55-60 patients

Physical Premises & Pediatric Inpatient Facilities

• MGH is located in a congested area of the city, accessible by all roads and major highways
• MGH is currently housed in mostly 1-story buildings that are, on average, 90 years old
• Pediatric wing consists of 60 beds in 2 general wards: (1) An open ward of 40 beds [2 story-unit] and (2) An open ward of 20 beds [1 story, 150 year-old unit]
• 20 bed special care nursery area
• 6 bed NICU area
• 8 bed diarrhea corner (in open ward)
• 3 bed High Dependency Area

Medical Equipment/Standard of Care

• 3 ventilators, but 0 with CPAP capability
• 2 nebulizers, but 0 functioning consistently or properly
• 1 cardiac monitor, but staff pediatricians report that it is unreliable
• 0 operational portable x-ray machines
• 0 CT Scans or MRI facilities
• 0 thyroid or thalessemia tests

Operational Status

• MGH is managed by the Ministry of Health
• MGH currently employs 3 full-time staff pediatricians and 1 neonatologist
• No pediatric surgeons
• 20 general nurses; 7 neonatal ICU nurses

Patient Conditions

• Most Common Pediatric Illnesses & Cases
• Respiratory – bronchiolitis asthma **(25% of inpatients – 100/month. Patients are treated with Salbutermol because no long-term medications are available.)
• Cerebral Palsy
• Epilepsy
• Both CP and epilepsy combined represent 25% of inpatients
• Dengue fever
• Meningitis (Haemophilus Influenza)
• Mumps (no subsidized vaccine provided)
• Nosocomial Infections **(15-20% of inpatients)
• Klebsiella (most common); MRSA; Streptococcus Faecalis
• Most common surgical cases: intussusception, diaphragmatic hernia repair, burns

Pediatric Outpatient Services

• 3 clinic sessions (2 general & 1 infant) per week
• Volunteer basis; use personal collection of medicines
• Recently providing increased amount of psychotherapy
• 100-150 patients seen per clinic session
• General clinic: long-term management of asthma; epileptics; juvenile RA
• Baby clinics: immunization & development assessment
• Birth – BCG (tuberculosis)
• 2/4/6 mos + 18 mos booster – Triple (tetanus/whooping cough/ diptheria – DPT + Oral Polio + Hep. B)
• 9 mos – Measles
• 3 yrs – MR (Measles and rubella) (No Mumps available)
• Haemophilus Influenza vaccine available for 1,250 sri lankan rupees (approx $13 US)

Imaging and Ancillary Services

• 1 portable x-ray (currently not operational)
• No CT scans or MRI facilities
• Labs: cbc, h&h, blood cx, urine cx, LPs – basic handled by hospital. No thyroid screening tests or thalassemia tests

Teaching Mission

• Pediatric Post-Graduates (Registrars): 4
• Senior House Officers: 4
• Interns: 4
• Medical Students: 10-15 total
• Pediatric rotation – perform H&P
• Nursing Students: 5-6 /yr